Provider Demographics
NPI:1558679019
Name:HANSEN, MARJORY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARJORY
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WHISPERING PINE WAY
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07438-8885
Mailing Address - Country:US
Mailing Address - Phone:973-208-2664
Mailing Address - Fax:
Practice Address - Street 1:154 S LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3017
Practice Address - Country:US
Practice Address - Phone:973-535-5010
Practice Address - Fax:973-535-8616
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00057300225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics